Non Rebreather Mask

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Now, we spoke about constant flow oxygen. And we're now gonna look at the non-rebreather mask. Now, there are more basic systems of this, but this is probably the most common one that's used. What we've got on the non-rebreather mask is a mask with oxygen tubing, and also a reservoir bag. The way these work is that the oxygen's going through the pipe. Once it's going through the pipe, it's entering into the bag, into the oxygen reservoir bag, and then the mask itself is secured around the patient's head. And you can adjust it by just pulling through on these straps. You can get it to a good fit. There is a metal clamp at the top that you can just gently squeeze around the nose to again, improve the seal. As the bag fills with oxygen, the patient breathes from the bag rather than directly from the pipe, so that's continually always flowing. And then when the exhale, it's blowing out through these valves. The inhale there is pure oxygen, and this is over 95%. It's a very good way of getting oxygen into somebody. But when they exhale, all that air goes right out.

We can't get absolutely 100% pure. We would have to be using something like a demand valve for that. But with this one, it gets as near as we can to that 100% mark. Now, as far as when you are using them, they are very straightforward. they are all single use, so once you get these, they come in a plastic bag, you open it up, when you finish with them, you just throwing them away. they are not something that you can clean because there are different fabric points, and they are not exactly very expensive. These currently are round about two, three pounds each, and often cheaper than that. It's a very straightforward, easy system. They come in different sizes. This is an adult size. There are also pediatric versions of it as well. The other thing you are getting with the kit is a small instructions or information about the mask itself, give basic information of what it's for and what it needs to be use for. Because they are single use and they are clean when they come through, then there's no problems with having to do any separate cleaning of them. You just open the bag and the use them straightaway.

The mask itself is connected just with push fit. you are not using any clamps, so it has a very straightforward, easy way of working. How you actually do it is take the cylinder, and on the end of the cylinder, you have got the constant flow. Just take the oxygen tubing and then just push that over the barbed outlet, so it's securely in place. The mask itself, you can, if you need to, just prime it by just popping your finger just over the top. That can help in some cases to inflate the bag. It's not usually needed. But all you are then doing is turning on the oxygen from the main tank. Turn on the flow rate at the top, so we're just allowing the oxygen to come out. And set that to start at 15 litres a minute. You can see the bag is then inflating and all that happened then is, as the patient breathes in, the bag goes down. And then as they... The bag is always full. The target is to always keep this bag full. Now, you can then slow the flow rate down if you need to, as long as the patient is getting that 100% oxygen. But leave it on and see what rating is needed.

When you have finished, just turn the tank off, remove the pipe from the end, and then remember we have to purge the regulator, so turn the main valve off, purge the regulator at the top, close that off, and then you can lay the cylinder down. How effective these are will vary on certain criteria. One would be the tidal volume. How much someone is actually breathing, whether they are breathing fast, whether they are breathing slow. And this can affect the flow rate you would put onto them. How well the mask actually seals around their face. If it's not a good seal, they are gonna be having air coming through the outside, mixing with the oxygen, and reducing the oxygen percentage. Now some people find these masks are a little bit claustrophobic when they are wearing them and they don't like them on there. Or they wear them around their neck because they are talking, or they are continually talking, bringing it away from their face.

The thing to do with a mask like this is to tell people why they need to have it on. you are not scaring people, but tell them it's important they keep it on. You can hear someone when they are talking through. It's not easy, but you can hear. Or just maybe, just pull it away for a second if you need to communicate with them. But just tell them to just breathe normally. Now, some people may confuse oxygen with something like Entonox. Now just say, "This is just oxygen. There's nothing special about it, in the sense you are not gonna feel any different." But medically, it will have a great impact on them. A bit of education, and also telling them about them about this and making sure it fits right, just to make sure they are comfortable while you are transporting them to the emergency medical services.